Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

This activity was supported by Contract No. 10002774 with the US Department of Health and Human Services [Centers for Disease Control and Prevention]. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

Additional copies of this report are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2016 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the public health problem of hepatitis B and C in the United States: Phase one report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Ralph J. Cicerone is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

CHRIS BEYRER, Johns Hopkins Bloomberg School of Public Health

JULES L. DIENSTAG, Harvard Medical School

NANCY DUNLAP, University of Virginia Medical School

JEREMY GOLDHABER-FIEBERT, Stanford University

AMY JESSOP, HepTREC University of the Sciences

ANNA S. LOK, University of Michigan Health System

CHARLES RICE, The Rockefeller University

CARLOS DEL RIO, Emory University

JOSHUA M. SHARFSTEIN, Johns Hopkins Bloomberg School of Public Health

SU H. WANG, Saint Barnabas Medical Center

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

its release. The review of this report was overseen by Robert B. Wallace, University of Iowa, and Don Eugene Detmer, University of Virginia School of Medicine. They were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Acknowledgments

The Committee on a National Strategy for the Elimination of Hepatitis B and C wishes to acknowledge the many people whose contributions and support made this report possible. The committee benefited from presentations made by a number of experts. The following individuals shared their research, experience, and perspectives with the committee: Adrian Di Bisceglie, Kyong-Mi Chang, Chari Cohen, Jules L. Dienstag, Brian R. Edlin, Marc Ghany, Robert G. Gish, J. Nadine Gracia, Camilla Graham, Jay Hoofnagle, Mandana Khalili, Arthur Kim, T. Jake Liang, Anna Suk-Fong Lok, Rohit Loomba, Brian McMahon, Dan O’Connell, Lara Strick, David L. Thomas, and John Ward.

The following individuals were important sources of information, generously giving their time and knowledge to further the committee’s efforts: Amy Geller, Scott Holmberg, Abbe Mitchell, Stephanie Scappini, Patti Simon, Norah Terrault, and Chia Wang.

The committee also benefited from the work of committees of the Institute of Medicine that conducted studies relevant to this report, particularly the Committee on a National Strategy for Prevention and Control of Viral Hepatitis Infections in the United States.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Finally, funding for this project was provided by the Centers for Disease Control and Prevention, Division of Viral Hepatitis, and the US Department of Health and Human Services, Office of Minority Health. The committee extends special thanks for that support.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. Washington, DC: The National Academies Press. doi: 10.17226/23407.

Hepatitis B and C cause most cases of hepatitis in the United States and the world. The two diseases account for about a million deaths a year and 78 percent of world’s hepatocellular carcinoma and more than half of all fatal cirrhosis. In 2013 viral hepatitis, of which hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common types, surpassed HIV and AIDS to become the seventh leading cause of death worldwide.

The world now has the tools to prevent hepatitis B and cure hepatitis C. Perfect vaccination could eradicate HBV, but it would take two generations at least. In the meantime, there is no cure for the millions of people already infected. Conversely, there is no vaccine for HCV, but new direct-acting antivirals can cure 95 percent of chronic infections, though these drugs are unlikely to reach all chronically-infected people anytime soon. This report, the first of two, examines the feasibility of hepatitis B and C elimination in the United States and identifies critical success factors. The phase two report will outline a strategy for meeting the elimination goals discussed in this report.

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